| NPI | 1508176967 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP119613) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 716395) | 
| Enumeration Date | 2010-10-19 | 
| Last Update Date | 2022-11-02 |